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<body>
<table width="100%">
    <tr>
        <td align="right">Close Date关闭时间：</td>
        <td>
            <input class="easyui-datebox">
        </td>
        <td align="right">Claimed声明：</td>
        <td>
            <input type="text"/>
        </td>
    </tr>
    <tr>
        <td align="right">Claim Situation声明情形：</td>
        <td colspan="3">
            <input id="cs_a" type="checkbox" style="width: 10px;"/><label for="cs_a" title="immediate actions立即行动">A</label>
            <input id="cs_b" type="checkbox" style="width: 10px;"/><label for="cs_b" title="failure cause故障原因">B</label>
            <input id="cs_c" type="checkbox" style="width: 10px;"/><label for="cs_c" title="corrective actions纠正措施">C</label>
            <input id="cs_d" type="checkbox" style="width: 10px;"/><label for="cs_d" title="close/efficiency关闭/效率">D</label>
            <input id="cs_e" type="checkbox" style="width: 10px;"/><label for="cs_e" title="answer to problem回答问题速度">E</label>
        </td>
    </tr>
    <tr>
        <td align="right">Affected Parts影响部分：</td>
        <td>
            <input type="text"/>
        </td>
        <td align="right">Remarks评论：</td>
        <td>
            <input type="text"/>
        </td>
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